To report visual acuity and anatomic outcomes, as well as complications, associated
with giant retinal tear management using intraoperative perfluoro-n-octane and to
investigate clinical features associated with anatomic and visual acuity outcomes.
A prospective, noncomparative, observational, multicenter study.
Two hundred twelve patients (212 eyes) > or =15 months of age who underwent giant
retinal tear management with intraoperative perfluoro-n-octane at 24 study sites between
April 1994 and February 1996. Giant retinal tear was defined as a retinal tear extending
> or =90 degrees.
Vitrectomy with perfluoro-n-octane intraoperative retinal tamponade.
Visual acuity and rates of retinal reattachment, reoperation, retained perfluoro-n-octane,
corneal edema, elevated intraocular pressure (IOP > 25 mmHg), hypotony (IOP < 5 mmHg),
and cataract. All outcome measures were assessed at 1 day, 1 week, 1 month, 3 months,
and 6 months postoperatively and at the last examination.
The study included 212 eyes of 212 patients followed a median of 3.5 months. Visual
acuity > or =20/200 was measured in 56 (27%) patients preoperatively and 67 (47%)
patients at 6 months. Postoperative visual acuity improved in 107 (59%) eyes, remained
stable in 44 (24%) eyes, and worsened in 29 (16%) eyes (percentages are based on the
number of patients for whom the data were available at these time points). Of the
124 patients with visual acuity < or =5/200 preoperatively, 94 (76%) had improved
visual acuity at 6 months postoperatively. At 6 months, the retina was attached in
108 (76%) eyes, and retained perfluoro-n-octane was noted in 8 (6%) eyes. Throughout
follow-up, 64 (30%) eyes underwent reoperation for recurrent retinal detachment. At
6 months, corneal edema, elevated IOP, and hypotony were noted in 5 (4%), 4 (3%),
and 12 (9%) eyes, respectively. Of the 72 phakic eyes without cataract preoperatively,
61 (85%) had a cataract or underwent cataract extraction during study follow-up. Factors
significantly (P < 0.05) associated with recurrent retinal detachment include female
gender, younger age, preoperative proliferative vitreoretinopathy, prior vitrectomy,
larger size of giant retinal tear, lack of scleral buckle placement, and relaxing
retinotomy. Multivariate analysis demonstrated that female gender, larger size of
giant retinal tear, and prior vitrectomy were significantly associated with recurrent
detachment. Factors significantly associated with vision >or =20/200 include male
gender, no prior vitrectomy, better preoperative vision, and no need for relaxing
retinotomy. After adjusting for recurrent detachment, factors significantly associated
with vision > or =20/200 include no prior vitrectomy, better preoperative vision,
and no need for relaxing retinotomy.
Retinal reattachment and preserved visual acuity were achieved in most eyes that underwent
giant retinal tear management with intraoperative perfluoro-n-octane. Significant
risk factors for recurrent retinal detachment include size of retinal tear, age, prior
vitrectomy, and female gender. After adjusting for recurrent detachment, significant
predictors of postoperative vision >or =20/200 include no prior vitrectomy, better
preoperative vision, and no need for relaxing retinotomy.